According to a survey, 85% of managers reported that their clinics faced staffing shortages, though only one in five blamed these on the US President’s Emergency Plan For Aids Relief cuts
A health monitoring organisation has found that, in areas with a high number of people with HIV, US funding cuts have led to staff shortages and overburdened clinics.
The cuts in the US President’s Emergency Plan For Aids Relief (Pepfar) in February created a massive shortfall in funding to South Africa’s HIV programmes.
The treasury agreed to fund about R753 million to cover some of the shortfall. (Measuring the total Pepfar shortfall is complicated but it is roughly R7 billion.)
A report over three months by Ritshidze — a South African community-led clinic monitoring organisation — shows that Pepfar cuts to HIV programmes have led to reduced staff and longer waiting times for ARV medicines.
From April to June Ritshidze monitored over 325 facilities in 16 districts across six provinces. Most were Pepfar-priority districts or formerly Pepfar-supported districts where contracts have been cut.
Thousands of patients and people living with HIV were surveyed, as well as staff at the clinics.
Nearly half the staff surveyed reported capacity in clinics had been reduced, because Pepfar-funded health workers were not working there anymore or were working less and 85% of managers reported that their clinics faced staffing shortages, though only one in five blamed shortages on Pepfar staff cuts.
Patients surveyed reported challenges with staffing at clinics. Over 60% reported that there were too few staff. These shortages have got worse since Pepfar cuts.
The worst-performing districts from patient reports on staff shortages were Johannesburg, and three Free State municipalities: Lejweleputswa, Mangaung and Thabo Mofutsanyana.
The surveys found waiting times in several districts have increased due to staff shortages. A fifth of healthcare users said waiting times were longer than usual. This was particularly bad in the Mangaung district (with 72% saying waiting times were longer), Buffalo City (34%) and King Cetshwayo in KwaZulu-Natal. About 35% said it had taken longer to collect ARVs since February.
The report found that disorganised filing systems frequently
caused delays and increased waiting times.
Staff reported HIV testing has been hit. 20% of surveyed staff said that following Pepfar cuts, there were fewer staff to provide testing and not enough test kits were available.
Ritshidze said with less testing, it becomes harder to identify people with HIV who need to start or restart treatment. About 1.1 million people with HIV are not receiving treatment, according to the health department.
TAC and Ritshidze have recommended people be given a six-month supply of ARVs in all provinces. Currently patients get a one- or three-month supply.
Health department spokesperson Foster Mohale had not responded by the time of publication.
This story was first published by GroundUp.